Understanding Lip-Ties in Infants and Their Impact on Feeding

When I assess an infant for a lip-tie (abnormal frenum attachment), I consider several factors, including the following: Where is the frenum attached? What is the size of the frenum? Does the lip have full range of motion? Does lifting the lip cause discomfort for the baby? These questions, along with a thorough review of the patient’s medical history and chief complaint, help guide me in determining whether this particular frenum attachment is interfering with the baby's ability to function as expected—in this case, the ability to breastfeed.

With infants, one of the biggest indicators for treating a lip-tie is their inability to develop a deep latch while breastfeeding. A shallow latch, caused by the lip’s inability to fully extend toward the nose, may lead the infant to retract, bite down, or curl in the lip to prevent discomfort or pain. This reluctance to fully extend the lip can result in the mother experiencing pain during latch initiation or after latching, difficulty for the baby in maintaining a seal (leading to air intake), and frustration on the baby’s part during breastfeeding.

Infants who have their lip-tie treated often show immediate improvement after the procedure. Our protocol is to have the baby attempt to breastfeed immediately afterward. It is not uncommon for mothers to cry tears of relief when they notice an immediate improvement in their infant’s ability to latch. Following the procedure, mothers generally report a 50% decrease in pain with the first latch and significant improvement by the time they return for their one-week follow-up. I have found that if the mother is already sore prior to the procedure, it may take a few days for her to heal before she can experience minimal to no pain during latching.

As I’ve stated before, I believe that working with a lactation consultant both before and after the procedure helps both the mother and infant progress more quickly toward their goal of having a successful breastfeeding experience. If you feel your infant is struggling with latching, please consult a lactation consultant—preferably an IBCLC (International Board Certified Lactation Consultant).

Dr. Rodenberg is a Board-Certified Pediatric Dentist who practices in the Louisville, Kentucky area and is the founder of the Kentucky Tongue-Tie Center.